{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:52:16Z","timestamp":1791597136399,"version":"4.3.4"},"reference-count":29,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T00:00:00Z","timestamp":1788652800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Previous studies examining Histoplasma antigen trends are largely in people with human immunodeficiency virus (PWH) before the antiretroviral therapy era, with limited generalizability to modern cohorts of histoplasmosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single-center, retrospective study of adult patients diagnosed with histoplasmosis by positive antigen testing and undergoing treatment between 2007 and 2021. Mean rates of antigen clearance (in log10\u2005ng\/mL) were estimated using a linear mixed-effects model. Time to H capsulatum antigen negativity was calculated using competing risk analysis. Per-patient, mean antigen levels were compared at time of diagnosis and subsequent 6-month intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 83 patients met the inclusion criteria: 25 transplant, 21 immunocompetent, 16 biologic therapy, 11 PWH, and 10 with other immunocompromise (OI). The transplant (\u22120.07), biologic (\u22120.07), and OI (\u22120.05) groups cleared antigenuria significantly slower than PWH (\u22120.21) and the immunocompetent group (\u22120.16). Median time to antigen negativity in the presence of competing risk of death was as follows: transplant, 20.3 (95% CI: 11.6\u201369.3) months; biologic, 14.6 (9.0\u201342.6) months; OI, 13.2 (2.0\u201382.5) months; PWH, 12.9 (1.9\u201319.2) months; and immunocompetent, 6.8 (2.8\u201313.0) months. At 1 year, antigen positivity was more common in immunocompromised than immunocompetent patients (22\/40 [55%] vs 3\/16 [19%]; P = .02) and among the immunocompromised groups only transplant, biologic, and OI patients had positivity at 2 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with chronic non-HIV immunosuppression demonstrated persistent antigenuria and cleared antigen more slowly compared with immunocompetent patients and immune-reconstituted PWH. Given the association of antigen persistence with immune status, its clinical significance in non\u2013HIV-immunocompromised populations requires evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag533","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:19:15Z","timestamp":1788520755000},"source":"Crossref","is-referenced-by-count":0,"title":["<i>Histoplasma capsulatum<\/i>\n                    Antigen Persistence and Rate of Decay During Treatment of Histoplasmosis Varies by Immune Status"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1035-7997","authenticated-orcid":false,"given":"Samuel M","family":"Fallon","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, John T. Milliken Department of Medicine, Washington University School of Medicine , St. Louis, Missouri ,","place":["USA"]},{"name":"Department of Medicine, Vanderbilt University Medical Center , Nashville, Tennessee ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8561-5463","authenticated-orcid":false,"given":"Julio C","family":"Zuniga-Moya","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, John T. Milliken Department of Medicine, Washington University School of Medicine , St. Louis, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9555-2550","authenticated-orcid":false,"given":"Adriana","family":"Rauseo","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, John T. Milliken Department of Medicine, Washington University School of Medicine , St. Louis, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1368-2226","authenticated-orcid":false,"given":"Marcela Araujo","family":"de Oliveira Santana","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, John T. Milliken Department of Medicine, Washington University School of Medicine , St. Louis, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4123-0518","authenticated-orcid":false,"given":"Patrick B","family":"Mazi","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, John T. Milliken Department of Medicine, Washington University School of Medicine , St. Louis, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7612-4710","authenticated-orcid":false,"given":"Andrej","family":"Spec","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, John T. Milliken Department of Medicine, Washington University School of Medicine , St. Louis, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,6]]},"reference":[{"key":"2026100921465220200_ciag533-B1","doi-asserted-by":"crossref","first-page":"ofv219","DOI":"10.1093\/ofid\/ofv219","article-title":"Histoplasmosis-associated hospitalizations in the United States, 2001\u20132012","volume":"3","author":"Benedict","year":"2016","journal-title":"Open Forum Infect Dis"},{"key":"2026100921465220200_ciag533-B2","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1177\/2325957413500535","article-title":"Temporal trends, clinical characteristics, and outcomes of histoplasmosis in a tertiary care center in Kentucky, 2000 to 2009","volume":"13","author":"Myint","year":"2014","journal-title":"J Int Assoc Provid AIDS Care"},{"key":"2026100921465220200_ciag533-B3","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1093\/mmy\/myaa112","article-title":"A comparison of presentations and outcomes of histoplasmosis across patients with varying immune status","volume":"59","author":"Franklin","year":"2021","journal-title":"Med Mycol"},{"key":"2026100921465220200_ciag533-B4","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/0002-9343(92)90575-V","article-title":"Itraconazole therapy for blastomycosis and histoplasmosis. 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